Category: Therapy

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Research into Practice: A study of safety and tolerability of rotatory vestibular input for preschool children

The answer to a question on SI4OT, a FB group for OT’s curated by our social media team, includes this interesting article.

This study was focussing on the vestibular system, and the researchers tried to work out the exact amount of vestibular input needed in therapy. The results strongly suggest that it is very individualised and requires direct therapist observation to know. This is exactly in line with Ayres’ teachings. There is no exact amount that can be prescribed

A study of safety and tolerability of rotatory vestibular input for preschool children

The use of sensory input to support function, health and wellbeing is an art and a science.

The science is knowing for instance that habituation of tactile input to Ruffini nerve ending is usually fairly rapid – eg light touch as we put arms in shirt sleeves while habituation to pain receptors will vary a lot and maybe ongoing after tissue damage we can’t always see.

The art is that our response to sensory input to sensory systems will vary greatly and is very individualised. This response is not just linked to immediate registration and perception of the input – meaning and memory need to be considered too.  Think about happy smells and songs that stay in your head all day. Think too about the response to trauma when a person smells their abuser’s perfume.

There is no recipe for how much to give and when. This is the art and science of ASI. So many factors impact on what a person needs and when to have an adaptive response.

This is why sensory input is not just something you can prescribe someone by saying;

“Give Jane 20 mins on a swing 3x a day” 

gray swing

Essential to practice is the person’s response to sensory input – Do they have an adaptive response?

“Ayres (1972b) described the adaptive response as central to praxis intervention. Adaptive responses are purposeful actions directed toward a goal that is successfully achieved, and the production of adaptive responses is thought to be inherently organizing for the brain. Ayres (1972b, 1985) further emphasized that SI intervention was a transaction among client, task, and environment.”

Bundy, A. and Lane, S. [2019], Sensory Integration Theory and Practice, 3rd Edition, [Philadelphia]. Available from: FADavis.

Watching and seeing this response to input, alongside feedback from the parents/family/person is what we do to understand each person’s unique responses and pattern. However, knowing and remembering that many things can impact on this, day to day and even minute by minute is essential. 

 

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CPD: Understanding and Applying Trauma-Informed Approaches Across Occupational Therapy Settings

AOTA has really helpful and supportive articles right now – promoting the best clinical practice, with an emphasis on participation in occupation.

This article is particularly pertinent to OT’s using ASI theory and practice to create therapeutic environments supporting and scaffolding participation in daily life for those with trauma.

Read the full article here.

 

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What is Ayres’ Sensory Integration Therapy?

At ASI Wise, to avoid confusion, we use the term sensory integration and processing difficulties. Different terms are used in different places to describe sensory integration difficulties. Some therapists may use sensory processing difficulties instead. Some may even use sensory processing disorder.

We currently have a robust test,  the SIPT, that allows us to describe sensory integration difficulties and reference research evidence to interpret the unique scores and pattern of scores that the child gets across 17 test items. We can use this data to inform our clinical reasoning, create a hypothesis about what sensory difficulties are contributing to participation challenges in everyday life. We set goals, plan and deliver the intervention, Ayres’ Sensory Integration Therapy measuring therapy outcomes. This is best practice.

“Active, individually tailored, sensory motor activities contextualised in play at the just right challenge, that targets adaptive responses for participation in activities and tasks.”

ESIC Schaaf 2019

Core to the practice of Ayres’ Sensory Integration is a central belief in the ‘adaptive response’.

“Ayres (1972b) described the adaptive response as central to praxis intervention. Adaptive responses are purposeful actions directed toward a goal that is successfully achieved, and the production of adaptive responses is thought to be inherently organizing for the brain. Ayres (1972b, 1985) further emphasized that SI intervention was a transaction among client, task, and environment.”

Bundy, A. and Lane, S. [2019], Sensory Integration Theory and Practice, 3rd Edition, [Philadelphia]. Available from: FADavis.

Ayres’ Sensory Integration assessment and therapy is typically post-graduate education for Occupational Therapists, Physiotherapists and Speech and Language Therapists. Please check that your therapist has ASI Education that meets level 2 education standards as recommended by ICEASI.

For more information about programmes offering Certification in Ayres’ Sensory Integration across the globe, please visit www.cl-asi.org.

 

Thank you Saša Radić – Kabinet aRTisINCLudum aRTis INCLudum for sharing these.

Read “Occupational Therapy Interventions for Children and Youth With Challenges in Sensory Integration and Sensory Processing: A School-Based Practice Case Example”  – one young person’s story from AJOT May 2019 here. [Frolek Clark et al 2019].

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An introduction to Ayres’ Sensory Integration

Sensory integration…the ability to organize sensory information for use…perception and synthesis of sensory data that enables man to interact effectively with the environment.’

Jean. A. Ayres (1972)

Screen Shot 2019-08-05 at 19.26.01

Ayres’ Sensory Integration combines theories and concepts from human development, current neuroscience, psychology with occupational science into a holistic framework through which we can consider a person’s development, learning and behavior. 

Integrating sensory input is essential for development, it underpins learning and ensures we can participate in daily life, helping us to ;

  • make sense of and join together cues in the environment
  • ‘do the right thing at the right time and in the ‘just right’ way’ – moving and using our bodies to get things done
  • be aware of what goes on within our own bodies;
  • know who we are – where we stop and start and where others begin
  • manage emotions and self -regulate
  • interact with others and the world around us – and safely

Here is a great resource to share with therapists, teachers, and families new to  Ayres’ Sensory Integration to help explain Ayres’ SI in more detail.

Thank you to Ms Grieco and Ms Wooldridge for sharing this on YouTube

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Choosing Wisely ® and ASI – a fantastic initiative from AOTA – it got me thinking about why people think sensory is easy and just anyone can do it.

Just like a parent can decide a child has a cold and needs Calpol, a sensory rich home environment can help support development. However just like a child may need a Dr, Dentist or other specialist if they have a more serious illness, what some people need is specialist intervention.

Sensory Integration therapy requires years of training, first just to become a therapist and then the advanced training needed to accurately assess, develop a personalised intervention plan and then carry out the intervention. We might all know when tonsils need removing, but few of us would do it at home. Telling someone about how tonsils get removed or how sensory integration happens is very different to actually doing it, and doing it safely and so that the outcome is as expected. Sensory integration therapy is not just about swinging on a swing or bouncing on a ball – it is about so much more. And is definitely not about just about wearing headphones and having a bouncy cushion.

The superb article from AOTA’s CHOOSING WISELY programme – see link below – got me thinking. I get weekly emails from people offering to treat other people’s children without training, offering Sensory Profile assessments by mail from a questionnaire when they are not even a therapist.

Share this blog and have interesting discussions with clients, colleagues and line managers. As relevant here in UK and Ireland as in US. This really confirms what we teach in our modules and promote as an organisation; including the best standardised norm referenced tool currently at our disposal – the SIPT. No or limited assessment waters down efficacy. Standardised assessment (when possible) structured clinical observations and thorough clinical reasoning using a clear process are imperative. Data driven decision making.

https://www.aota.org/AboutAOTA/Membership/Tools/Periodicals/choosing-wisely-sensory.aspx